CAJ | 학술논문

目的通过上肢易卡压部位神经电生理检查探讨银杏达莫联合甲钴胺对2型糖尿病患者周围神经病变的治疗作用. 方法选择河北联合大学附属医院内分泌科自2008年1月至2011年6月收治的208例2型糖尿病合并糖尿病周围神经病(DPN)患者为研究对象,采用随机数字表法将其分为治疗组(103例)和对照组(105例),2组患者同时采用糖尿病饮食、运动及降糖等基础治疗方案,对照组加用口服甲钴胺1000 μg,每日3次；治疗组在对照组治疗基础上联合应用银杏达莫注射液20 mL静脉滴注,每日1次.2组患者均连续应用4周.治疗前及治疗后4周,观察正中神经、尺神经感觉神经传导速度(SCV)、感觉神经电位(SNAP)、运动神经传导速度(MCV)、肌肉复合动作电位(CMAP)及远端潜伏期(DML)等指标变化. 结果 2组患者治疗后正中神经远端DML缩短、SCV增快、SNAP波幅增加,尺神经肘上下段MCV、SCV均较治疗前增快且SNAP波幅增高；治疗组各项指标均优于对照组,差异有统计学意义(P＜0.05). 结论易卡压部位神经电生理检查是评价DPN疗效的敏感指标,银杏达莫注射液与甲钴胺联合应用对于DPN具有良好的治疗作用.
목적 통과상지역잡압부위신경전생리검사탐토은행체막연합갑고알대2형당뇨병환자주위신경병변적치료작용. 방법 선택하북연합대학부속의원내분비과자2008년1월지2011년6월수치적208례2형당뇨병합병당뇨병주위신경병(DPN)환자위연구대상,채용수궤수자표법장기분위치료조(103례)화대조조(105례),2조환자동시채용당뇨병음식、운동급강당등기출치료방안,대조조가용구복갑고알1000 μg,매일3차；치료조재대조조치료기출상연합응용은행체막주사액20 mL정맥적주,매일1차.2조환자균련속응용4주.치료전급치료후4주,관찰정중신경、척신경감각신경전도속도(SCV)、감각신경전위(SNAP)、운동신경전도속도(MCV)、기육복합동작전위(CMAP)급원단잠복기(DML)등지표변화. 결과 2조환자치료후정중신경원단DML축단、SCV증쾌、SNAP파폭증가,척신경주상하단MCV、SCV균교치료전증쾌차SNAP파폭증고；치료조각항지표균우우대조조,차이유통계학의의(P＜0.05). 결론 역잡압부위신경전생리검사시평개DPN료효적민감지표,은행체막주사액여갑고알연합응용대우DPN구유량호적치료작용.
Objective To explore the effect of Ginkgo leaf extract and dipyridamole injection combined with methylcobalam on nerve conduction velocity of nerve entrapment sites in the upper limbs in patients with diabetic peripheral neuropathy (DPN).Methods Two hundred and eight type 2 diabetic patients with DPN,admitted to our hospital from January 2008 to June 2011,were selected in our study,and randomly divided into an observation group (n=103) and a control group (n=105).Dietary regulation,exercises and glucose control were conducted in both groups.In the control group,patients were given methylcobalamin at the dose of 1000 μg,three times a day.In the observation group,patients were given methylcobalamin (1000 μg,three times a day) plus Ginkgo leaf extract and dipyridamole injection of 20 mL once a day.All treatments lasted for four weeks.The sensory conduction velocity (SCV),motor conduction velocity (MCV) and sensory nerve action potential (SNAP),compound muscle action potential (CMAP) and distal motor latency (DML) of median and ulnar nerves were measured and compared before and four weeks after the treatments.Results The DML was shortened,and SCV and amplitude of median nerve were improved.Segmental MCV of above-below elbow,SCV and amplitude of ulnar nerve were significantly improved in both groups after the treatments as compared with those before treatment (P＜0.05); the total effective rate of the observation group was significantly higher than that of the control group (P＜0.05).Conclusion The nerve electrophysiological characteristics of nerve compression sites in the upper limbs is sensitive for assessing injury and treatment effect in patients with DPN; the combination of Ginkgo leaf extract and dipyfidamole injection and methylcobalam is superior than methylcobalam alone in improving the nerve conduction of diabetic patients.